Watch the following video that explains glaucoma
What is Glaucoma?
Glaucoma is a group of diseases that result in damage to the eye’s optic nerve. Glaucoma is generally related to a high eye pressure. Damage to the optic nerve initially results in a decreased vision and may eventually lead to blindness.
The optic nerve
The optic nerve is responsible for transmitting images from the eye to the brain. Damage to the optic nerve results in an abnormal transmission of the image, and in advanced glaucoma results in no image being transmitted to the brain.
How does the optic nerve get damaged by open-angle glaucoma?
High eye pressures are a risk factor for the development of glaucoma. In the front of the eye there is a chamber that gets filled with fluid. This clear fluid is constantly being produced. The fluid leaves the eye by draining through small channels. Blockage of these channels results in a high pressure in the eye. This high pressure is transmitted to the optic nerve, which over time becomes damaged by the high pressure.
If the drainage angle is open, this is referred to as open angle glaucoma. Fluid is obstructed from passing through this drainage area. Eventually this pressure rise damages the optic nerve.
High blood pressure is also a risk factor for the development of glaucoma. It is important that any elevated blood pressure is treated by your medical doctor.
Can I develop glaucoma if I have increased eye pressure?
Not every person with a high eye pressure develops glaucoma. Some people can tolerate high pressures in the eye without causing damage to the optic nerve.
Whether you develop glaucoma depends on the pressure in the eye that your optic nerve can tolerate. This pressure is different from person to person. A comprehensive eye exam by your ophthalmologist will assist in deciding if there is damage occurring to the optic nerve. Your eye doctor will conduct special tests that will aid in deciding if damage to the optic nerve is occurring .
Can I develop glaucoma without an increase in my eye pressure?
Yes. Some people develop glaucoma even though their eye pressure is normal. This is referred to as normal tension glaucoma.
Who is at risk for open-angle glaucoma?
Anyone can develop glaucoma. Some people, listed below, are at higher risk than others:
Patients of African descend over age 40
Everyone over age 60
People with a family history of glaucoma
A eye exam by your ophthalmologist may reveal other risk factors. These include: a high eye pressure, abnormally thin cornea or a abnormal optic nerve .
Initially glaucoma is a silent disease. Early stages has no symptoms. It causes no pain and vision is unaffected.
If left untreated, someone with glaucoma will eventually loose their periferal vision. Eventually the area of vision narrows, until eventually there is only tunnel vision. If the process of damage to the optic nerve continues, vision may decrease until there is no vision.
How is glaucoma detected?
Glaucoma is detected by a exam conducted by your eye doctor. Your eye surgeon will perform special tests that will aid in making a diagnosis. A comprehensive exam will include:
Visual acuity test. This eye chart test measures how well you see.
Visual field test. This test measures your peripheral (side vision). It aids your ophthalmologist in checking if any peripheral vision loss has occurred .
Dilated eye exam. In this exam, drops are placed in your eye to dilate your pupil. This allows a clear view of the optic nerve. Your eye specialist will look for specific signs of glaucoma. After this exam your near vision will be affected for a couple of hours. If you are driving, it is important to bring along someone to drive you back home.
Tonometry is the measurement of pressure inside the eye by using an instrument called a tonometer. Anesthetic drops are placed on the eye, and your eye doctor will measure the intra ocular pressure ( pressure inside the eye).
Pachymetry is a measure of the thickness of the cornea. A thin cornea is a risk factor for the development of glaucoma.
Can glaucoma be cured?
No. There is no cure for glaucoma. Vision lost from the disease cannot be restored. It is important to pick up the signs early in the disease so that deterioration can be stopped. Glaucoma can be controlled by controlling the eye pressure.
Immediate treatment for early-stage, open-angle glaucoma can delay progression of the disease. That’s why early diagnosis is very important.
Glaucoma treatments include:
Eye drops to decrease the eye pressure
Or a combination of these treatments.
These treatments prevent the disease from advancing, however they do not improve sight already lost from glaucoma
Eye drops that lower the eye pressure are commonly used to control the disease. They work by either causing less fluid to be produced in the eye or increasing the drainage out of the eye.
Glaucoma eye drops need to be used as prescribed by your ophthalmologist. Most people have no problems with the eye drops, however occasionally people may experience mild stinging, redness, headaches or other side effects.
Many medicines are available to treat glaucoma. If you have problems with one medicine, tell your eye specialist. Treatment with a different dose or a new medicine may be possible.
Because glaucoma is a silent disease, people may be tempted to stop their medications. You need to use your eye drops as long as indicated by your ophthalmologist. Regular use is important to control the disease.
Ensure that your glaucoma specialist shows you how to use your eye drops. Correct usage of your drops will ensure that they work effectively.
Laser trabeculoplasty. Laser trabeculoplasty helps fluid drain out of the eye. Laser treatment will lower the eye pressure by opening the drainage pathway.
A light beam is aimed at the drainage area of the eye, and the laser is applied. You may see flashes of light but no pain or discomfort is experienced. The procedure typically takes 5 to 10 minutes. After the procedure your vision is not affected. And you can continue your day as normal.
If you have glaucoma in both eyes, usually only one eye or both eyes may be treated at the same time. If one eye is done at a time, then the laser is scheduled for a few days or weeks apart.
Studies show that laser surgery can be very good at reducing the pressure in some patients. However, its effects can wear off over time, which typically lasts for 7 years on average. Your doctor may suggest further treatment as laser treatment is repeatable.
Conventional surgery. Surgery makes a new opening for the fluid to leave the eye. Your doctor may suggest this treatment at any time. Conventional surgery often is done as a last resort, if other treatments have failed.
Glaucoma surgery, called a trabeculectomy, is performed in a operating theatre. The surgery makes an alternative pathway for eye fluid to drain out.
For several weeks after the surgery, you must put drops in the eye to fight infection and inflammation. Glaucoma surgery is performed on one eye at a time.
What are some other forms of glaucoma and how are they treated?
Open-angle glaucoma is the most common form. Some people have other types of the disease.
In angle closure glaucoma, the drainage area becomes obstructed by the iris. The symptoms of angle closure glaucoma are very different to open angle glaucoma. Whereas open angle glaucoma is a silent disease, closed angle glaucoma is very sudden, with a painful eye. This is a medical emergency. Without treatment the eye will become blind within days.
What can you do?
If you have been diagnosed with glaucoma, ensure you use your medications correctly. See your eye surgeon in order to monitor the disease.
If you have been diagnosed with glaucoma, you can assist your family members by getting them to have a screening for glaucoma. Your ophthalmologist will screen family members for the disease. All people of African descend should be screened after the age of 40, and everyone over the age of 60. This should be performed every 2 years.
Some medical aids will cover the cost of a screening test for glaucoma. Glaucoma is a prescribed minimum benefit disease and will be covered by your medical aid.
What are some questions to ask?
About my eye disease or disorder…
What is my disease?
What caused my glaucoma?
Can my glaucoma be treated?
How will this condition affect my vision now and in the future?
Should I watch for any particular symptoms and notify you if they occur?
Should I make any lifestyle changes?
About my treatment…
What is the treatment for my high eye pressure?
When will the treatment start and how long will it last?
What are the benefits of this treatment and how successful is it?
What are the risks and side effects associated with glaucoma treatment?
Is there anything that I should avoid while I’m on this treatment?
If my treatment includes taking medicine, what should I do if I miss a dose?
Are other treatments available?
About my tests…
What kinds of tests will I have?
What can I expect to find from undergoing these tests?
Do I have to do anything special to prepare for any of the tests?
Do these tests have any side effects or risks?
Will I need more tests later?
If you don’t understand your ophthalmologists responses, ask questions until you do understand.
Take notes or get a friend or family member to take notes for you.
Ask your ophthalmologist to write down his or her instructions to you.
Ask your ophthalmologist for printed material about your condition.
Today, patients take an active role in their health care. Be an active patient about your eye care.
Ask your ophthalmologist for internet resources of information.
How should I use my glaucoma eyedrops?
If you are using eye drops ensure proper use. Proper use will ensure that the drops work effectively.
To properly apply your eyedrops, follow these steps:
Wash your hands.
Hold the bottle upside down.
Tilt your head back.
Hold the bottle in one hand and place it as close as possible to the eye.
With the other hand, pull down your lower eyelid. This forms a pocket.
Place the prescribed number of drops into the lower eyelid pocket. If you are using more than one eyedrop, be sure to wait at least 5 minutes before applying the second eyedrop.
Close your eye OR press the lower lid lightly with your finger for at least 1 minute. Either of these steps keeps the drops in the eye and helps prevent the drops from draining into the tear duct, which can increase your risk of side effects.